scholarly journals Perceptions Towards Childhood Asthma and Barriers To Its Management Among Patients, Caregivers and Healthcare Providers: A Qualitative Study From Ethiopia

2021 ◽  
Author(s):  
Eden Kassa ◽  
Rahel Argaw Kebede ◽  
Bruck Messele Habte
Keyword(s):  
Childhood Asthma ◽  
Inhaled Corticosteroids ◽  
Addis Ababa ◽  
Healthcare Providers ◽  
Asthma Management ◽  
Institutional Setting ◽  
Treatment Regimens ◽  
Recommended Treatment ◽  
Children With Asthma ◽  
Family Perceptions

Abstract Background The management of asthma, which is one of the major causes of childhood morbidity and mortality has been affected by non-adherence to recommended treatment regimens with severe consequences. The aim of the present study was therefore to explore the perceptions of the children with asthma, their caregivers and their healthcare providers towards asthma and barriers to long term childhood asthma management in an institutional setting in Addis Ababa, Ethiopia. Methods A qualitative descriptive design was followed for the present study that used individual interviews as a data collection method. The study participants were 23 pairs of children with asthma that had treatment follow ups in two tertiary hospitals and their caregivers and eight healthcare providers who cared for these children. The data was analyzed using thematic analysis approach. Results The study findings revealed that the children and their caregivers were facing physical, emotional and social burdens related with asthma and reported low adherence to their recommended treatment regimens. Factors affecting childhood asthma management were found to be limited awareness about asthma and its management and inadequate education received from healthcare professionals. Non-adherence to especially inhaled corticosteroids appears to be influenced by necessity beliefs towards chronic administration of treatment regimens and concerns related with difficulty of administration, fear of side effects and general bad attitude towards it, in addition to their low availability and affordability. Conclusions Varied perceptions about asthma and its management were reported by children with asthma and their caregivers compared to the biomedical recommendation that were related to different factors. This in turn may contribute to the low adherence of the children to their recommended regimens and suboptimal health outcomes. The findings support the need for strong asthma care and education programs that are sensitive to local and individual patients’ and family perceptions and experiences including emotional distress and of the need to institute chronic care approach.

Illness and treatment perceptions of patients with epilepsy attending their treatment at tertiary hospital in Addis Ababa, Ethiopia–a qualitative exploration

2019 ◽  
Author(s):  
Bezawit Negash Demissie ◽  
Abenet Tafesse Mengesha ◽  
Bruck Messele Habte
Keyword(s):  
Addis Ababa ◽  
Healthcare Providers ◽  
Spiritual Healing ◽  
Tertiary Hospital ◽  
Healthcare Provision ◽  
Treatment Regimens ◽  
Recommended Treatment ◽  
Treatment Perceptions ◽  
Patients With Epilepsy ◽  
Qualitative Exploration

Abstract Background Epilepsy can be a large economic burden in countries where appropriate treatment is not taken due to religious and psychosocial beliefs. Objective To explore the perceptions and experiences of patients with epilepsy attending their treatment at Tikur Anebessa Specialized Hospital about their illness and treatment. Methods A qualitative exploratory design with an in-depth interview with fourteen purposively selected patients was used until saturation of key emerging themes was achieved. Result The finding showed that study participants experienced delay in treatment-seeking and non-adherence to recommended treatment regimens and as well use of traditional medicine and spiritual healing. Some of the possible reasons for their reported behaviors include alternative perceptions that they have about their illness, social and psychological issues that they face, concerns about their medications alongside with dissatisfaction with their healthcare providers. On the other hand, reasons that were reported to positively influence their treatment experiences include necessity perceptions about their medications, family support and use of spiritual healing alongside their biomedical treatment. Conclusion The healthcare provision should improve to cater to these groups of patients including instituting chronic care management and appropriate health education provision.

scholarly journals The PUFFinCA scale: development of an instrument for evaluating the primary care functions of family physicians in childhood asthma

2018 ◽  
Vol 20 ◽  
Author(s):  
Ayşe Nur Usturali Mut ◽  
Zeliha Aslı Öcek ◽  
Meltem Çiçeklioğlu ◽  
Şafak Taner ◽  
Esen Demir
Keyword(s):  
Primary Care ◽  
Childhood Asthma ◽  
Assessment Tool ◽  
Asthma Management ◽  
Correlation Coefficients ◽  
Family Physicians ◽  
Principal Component ◽  
Care Assessment ◽  
Provision Of Services ◽  
Children With Asthma

AbstractAimTo develop the Primary care fUnctions oF Family physicians in Childhood Asthma (PUFFinCA) scale for evaluating the cardinal process functions of primary care services (accessibility, comprehensiveness, continuity and coordination) provided by family physicians (FPs) in the management of childhood asthma.BackgroundIn the literature on the functions of primary care, there is no assessment tool focusing on children with asthma. Primary care assessment scales adapted to various languages are not suitable to adequately address the needs of special patient groups, such as children with asthma.MethodsIn this methodological study, the instrument development process was completed in four stages: establishing the pool of items, evaluating the content validity, applying the scale and statistical analysis. The scale was applied to 320 children who had asthma and received care in the clinic of the Department of Pediatrics, Division of Allergy and Pulmonology at Ege University School of Medicine, Turkey. The Cronbach’s α and Spearman–Brown coefficient were calculated to determine the reliability of the scale. Principal component analysis was used to determine the construct validity of the scale.FindingsThe PUFFinCA scale was found to have four-factor structure and 25 items. Cronbach’s α coefficient was 0.93. It has been determined that the reliability was excellent and the item-total correlation coefficients were >0.30 each. The factors were titled FP’s ‘functions of accessibility, first contact and continuity’, ‘functions of coordination and comprehensiveness of health services related to asthma management’, ‘provision of preventive care related to asthma’ and ‘provision of services for paid vaccinations’.

scholarly journals CASTER: Cross-Sectional Asthma STEroid Response Measurement

2020 ◽  
Vol 10 (3) ◽  
pp. 95
Author(s):  
Alvin T. Kho ◽  
Joanne Sordillo ◽  
Ann Chen Wu ◽  
Michael H. Cho ◽  
Sunita Sharma ◽  
...  
Keyword(s):  
Childhood Asthma ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Clinical Information ◽  
Asthma Patient ◽  
Management Program ◽  
Poor Responders ◽  
Response Measurement ◽  
Cross Sectional ◽  
Steroid Response

Asthma patient response to inhaled corticosteroids (ICS) is variable and difficult to quantify. We aimed to define a measure of steroid response suitable for pharmacogenetic research in longitudinal and cross-sectional cohorts. Using longitudinal data from the Childhood Asthma Management Program (CAMP) asthma cohort, we defined the Cross-sectional Asthma STEroid Response (CASTER) measure in cross-sectional data. We then applied this to cross-sectional slices of four independent asthma cohorts: The Improving Asthma Control Trial (IMPACT), the Salmeterol or Corticosteroids Study (SOCS), the Pediatric Asthma Controller Trial (PACT), and the Genetics of Asthma in Costa Rica Study (GACRS). CASTER achieved high accuracy on the childhood asthma cohorts: GACRS, PACT, and also on cross-sectional data from CAMP (AUCs 82%, 71%, 63%, respectively). This demonstrates that select cross-sectional clinical information is sufficient to identify good and poor responders to ICS treatment in childhood asthma. Thus, CASTER represents a major improvement in the usability and applicability of steroid response measures in asthma research.

scholarly journals Neutrophils in asthma: the good, the bad and the bacteria

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-215986
Author(s):  
Helena Crisford ◽  
Elizabeth Sapey ◽  
Geraint B Rogers ◽  
Steven Taylor ◽  
Prasad Nagakumar ◽  
...  
Keyword(s):  
First Nations ◽  
Airway Inflammation ◽  
Inhaled Corticosteroids ◽  
Scientific Discovery ◽  
Age Groups ◽  
Asthma Management ◽  
Children With Asthma ◽  
First Nations People ◽  
The Life Course

Airway inflammation plays a key role in asthma pathogenesis but is heterogeneous in nature. There has been significant scientific discovery with regard to type 2-driven, eosinophil-dominated asthma, with effective therapies ranging from inhaled corticosteroids to novel biologics. However, studies suggest that approximately 1 in 5 adults with asthma have an increased proportion of neutrophils in their airways. These patients tend to be older, have potentially pathogenic airway bacteria and do not respond well to classical therapies. Currently, there are no specific therapeutic options for these patients, such as neutrophil-targeting biologics.Neutrophils comprise 70% of the total circulatory white cells and play a critical defence role during inflammatory and infective challenges. This makes them a problematic target for therapeutics. Furthermore, neutrophil functions change with age, with reduced microbial killing, increased reactive oxygen species release and reduced production of extracellular traps with advancing age. Therefore, different therapeutic strategies may be required for different age groups of patients.The pathogenesis of neutrophil-dominated airway inflammation in adults with asthma may reflect a counterproductive response to the defective neutrophil microbial killing seen with age, resulting in bystander damage to host airway cells and subsequent mucus hypersecretion and airway remodelling. However, in children with asthma, neutrophils are less associated with adverse features of disease, and it is possible that in children, neutrophils are less pathogenic.In this review, we explore the mechanisms of neutrophil recruitment, changes in cellular function across the life course and the implications this may have for asthma management now and in the future. We also describe the prevalence of neutrophilic asthma globally, with a focus on First Nations people of Australia, New Zealand and North America.

scholarly journals When Control Exacerbates Distress: A Qualitative Study Exploring the Experiences of Hong Kong Chinese Parents in Caring for a Child with Asthma

2018 ◽  
Author(s):  
Yuen-yu Chong ◽  
Doris Leung ◽  
Yim-wah Mak
Keyword(s):  
Hong Kong ◽  
Childhood Asthma ◽  
Asthma Management ◽  
Structured Interviews ◽  
Educational Training ◽  
Chinese Parents ◽  
Children With Asthma ◽  
Qualitative Descriptive ◽  
Conventional Content Analysis ◽  
Primary Form

Many parents have difficulty managing childhood asthma. In Hong Kong (HK), while medication is the primary form of treatment, traditional Chinese medicine is another favored option. In addition, HK follows a dual-track healthcare system, which may pose unique experiences for Chinese parents in childhood asthma management. This qualitative descriptive study aimed to explore the experiences of HK Chinese parents in caring for their children with asthma. Methods: Fourteen HK Chinese mothers of children (aged 3-10) suffering from asthma were purposively sampled to participate in individual, semi-structured interviews. A realist approach following conventional content analysis was used to interpret the interviews. Results: The mothers expressed feelings of uncertainty, fear of asthma crises, and searching for ways to cope. These feelings triggered various strategies to control their child’s asthma. As long as the child’s asthma symptoms recurred, the mothers’ distress continued. Their distress was sometimes exacerbated by self-doubt and worries about whether they would receive adequate support from their family and healthcare professionals. Conclusion: Helping parents to understand their limits may help them be more open to varied aspects of their caregiving experiences, and thus to cope better. Psychological interventions together traditional educational training may help to alleviate parents’ psychological difficulties.

Management Considerations for Chronic Asthma

2001 ◽  
Vol 14 (2) ◽  
pp. 108-125
Author(s):  
Sharya Vaughan Bourdet ◽  
Dennis Williams
Keyword(s):  
Inhaled Corticosteroids ◽  
Environmental Control ◽  
Management Strategies ◽  
Asthma Management ◽  
The United States ◽  
Control Measures ◽  
Ongoing Research ◽  
Common Chronic Disease ◽  
Children With Asthma

Asthma is a common chronic disease affecting millions of individuals in the United States. Appropriate management and prevention of asthma symptoms is essential in order to maintain quality of life and reduce healthcare costs. Published consensus guidelines provide recommendations for asthma management and emphasize pharmacologic and nonpharmacologic components for long-term management. Major components of asthma management include environmental control measures, patient education and self-management, pharmacotherapy and periodic assessment. Since publication of the guidelines in 1997, there has been additional research and advances in our knowledge and understanding of asthma. Ongoing research focuses on issues such as regular versus as needed use of short-acting bronchodilators, early initiation of inhaled corticosteroids, safety of inhaled corticosteroids in children with asthma, combination therapy with inhaled corticosteroids and other long-term control agents, and reduction of inhaled corticosteroid doses. Advances in therapy and new knowledge about appropriate management strategies should be incorporated into clinical management strategies.

scholarly journals Factors related to under-diagnosis and undertreatment of childhood asthma in metropolitan France

2012 ◽  
Vol 7 ◽  
Author(s):  
Isabella Annesi-Maesano ◽  
Carla Sterlin ◽  
Denis Caillaud ◽  
Fréderic De Blay ◽  
François Lavaud ◽  
...  
Keyword(s):  
Childhood Asthma ◽  
Asthma Management ◽  
International Study ◽  
Good Control ◽  
Medical Visit ◽  
Positive Skin ◽  
Children With Asthma ◽  
Potential Risk Factors ◽  
Using Data ◽  
Exercise Induced

Background: Under-diagnosis and under-treatment of childhood asthma were investigated in France using data collected during the 6 Cities Study, the French contribution to the International Study of Asthma and Allergies in Childhood. Methods: 7,781 schoolchildren aged between 9 and 10 years underwent a medical visit including skin prick tests to common allergens and exercise test for Exercise-Induced Asthma (EIA) and their parents filled in a standardized questionnaire on asthma, management, treatment and potential risk factors. Results: 903 children reported asthma (11.6%), 377 without a doctor’s diagnosis. Of the 526 participants with a diagnosis of asthma confirmed by a doctor (58.2%), 353 were treated and 76 were not treated during the year preceding the investigation despite their diagnosis. The information on the treatment was missing for the rest of individuals diagnosed with asthma (n = 97). Having a treatment was significantly associated with severe asthma and with the presence of other respiratory and allergic stigmata (atopic eczema, rhinitis, positive skin allergy tests, and EIA). In addition, having a treatment did not correspond to a good control of the disease. Similarly, children with asthma-like symptoms but without doctor-diagnosed asthma had asthma less well controlled than children with diagnosed asthma. They were also more exposed to passive smoking and traffic but had fewer pets. In contrast, diagnosed children reported more frequently a small weight at birth and a preterm birth. Conclusions: In France, childhood asthma is still under-diagnosed and under-treated and environmental factors play a role in these phenomena.

scholarly journals Managing problematic severe asthma: beyond the guidelines

2017 ◽  
Vol 103 (4) ◽  
pp. 392-397 ◽  
Author(s):  
Katharine C Pike ◽  
Mark L Levy ◽  
John Moreiras ◽  
Louise Fleming
Keyword(s):  
Young People ◽  
Severe Asthma ◽  
Inhaled Corticosteroids ◽  
Symptom Control ◽  
Asthma Management ◽  
Children And Young People ◽  
Leading Role ◽  
Children With Asthma ◽  
Individualised Care ◽  
New Treatments

This review discusses issues related to managing problematic severe asthma in children and young people. A small minority of children have genuinely severe asthma symptoms which are difficult to control. Children with genuinely severe asthma need investigations and treatments beyond those described within conventional guidelines. However, the majority of children with poor symptom control despite high-intensity treatment achieve improvement in their asthma control once attention has been paid to the basics of asthma management. Basic asthma management requires optimisation of inhaler technique and treatment adherence, avoidance of environmental triggers and self-management education. It is also important that clinicians recognise risk factors that predispose patients to asthma exacerbations and potentially life-threatening attacks. These correctable issues need to be tackled in partnership with children and young people and their families. This requires a coordinated approach between professionals across healthcare settings. Establishing appropriate infrastructure for coordinated asthma care benefits not only those with problematic severe asthma, but also the wider asthma population as similar correctable issues exist for children with asthma of all severities. Investigation and management of genuine severe asthma requires specialist multidisciplinary expertise and a systematic approach to characterising patients’ asthma phenotypes and delivering individualised care. While inhaled corticosteroids continue to play a leading role in asthma therapy, new treatments on the horizon might further support phenotype-specific therapy.

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